The Clinical Validation Studies Of X Syndrome Guide Based On Literature Review And Delphi

ObjectiveJoin into the team of develop guidelines. Searching the literature of TCM syndrome differentiation and treatment, develop inclusion criteria and exclusion criteria, useing the method of evidence-based medicine to evaluation the literature that inchued, changing into the recommendations according to the Grade.MethodsBased on the literature evaluation, and consult the method of evidence-based clinical practice guidelines in TCM (internal medicine of TCM), design the expert questionnaire of cardiac X syndrome, and select expert to fill out it, evaluate the questionnaires and put forward some advices of it. Follow the Delphi, evaluate the experts’opinion and discuss, then Get guidelines.Using prospective clinical case observation method, cerebral infarction cases were observed by Guangdong TCM Hospital, compared the clinical treatment scheme with TCM clinical practice guideline of cardiac X syndrome,, meanwhile, fill out the application and evaluation questionnaire of TCM clinical practice guideline of cardiac X syndrome, using statistics method of descriptive analysis, GRI association rules algorithm, Logistic regression analysis.ResultIn total,878 literatures were included,645 literatures were included after removed duplicate, get 109 literatures after preliminary findings, inclused 35 literature after browsing and analysis it, then get 7 literature.All of the experts that we choosed were cardiovascular medicine physician, there are 3 of them enjoy government subsidies,70% of them are senior titles, more than 76% of them are master.51 questionnaires were sent,50 questionnaires were recycled, the recovery rate is 98%. all of the recovery questionnaire were put forward opinions to 29 item in full. The agreed rate about the definition of cardiac X syndrome is 96%, the agreed rate about the definition of MVA is 98%, the agreed rate about description of MVA is 96%, the agreed rate about differentiation of TCM of this disease is 86%, the agreed rate of the dialectic standard of Qizhi is 80%, the agreed rate of the dialectic standard of phlegm syndrome is 88%,the agreed rate of the dialectic standard of coagulated cold syndrome is 88%, the agreed rate of the dialectic standard of blood stasis syndrome is 88%, the agreed rate of the dialectic standard of Qi deficiency is 90%, the agreed rate of the dialectic standard of yin deficiency is 92%, the agreed rate of the dialectic standard of yang deficiency is 84%, the agreed rate of the dialectic standard of heart blood stasis syndrome is 94%, the agreed rate of the dialectic standard of Qi stagnation and blood stasis syndrome is 88%, the agreed rate of the dialectic standard of Qi deficiency and blood stasis syndrome is 98%, the agreed rate of the dialectic standard of Qi asthenia and phlegm-stasis syndrome is 94%, the agreed rate of the dialectic standard of Qi-Yin deficiency syndrome is 90%, the agreed rate of the typing treatment of heart blood stasis syndrome is 88%, the agreed rate of the typing treatment of Qi stagnation and blood stasis syndrome is 90%, the agreed rate of the typing treatment of Qi deficiency and blood stasis syndrome is 68%, the agreed rate of the typing treatment of Qi asthenia and phlegm-stasis syndrome is 86%, the agreed rate of the typing treatment of Qi-Yin deficiency syndrome is 78%,the agreed rate of traditional Chinese Medicine and its levels of evidence is 92%, the agreed rate of acupuncture therapy and its levels of evidence is 90%.According to experts’opinions, improving the guide. Design the application and evaluation questionnaire of TCM clinical practice guideline of cardiac X syndrome, and research the clinical validation of it, we found that the highest coincidence rate is TCM diagnosis and Western medicine diagnosis, they are 99.00%(198cases)and 100.00% (200cases), slight lower is syndrome classification and therapeutic principle, they are 95.00%(190cases) and 96.00%(192cases), the coincidence rate of the treatment is lower than the dialectical, the coincidence rate of Prescription, Chinese patent medicine, other preparation is 88.00%(176cases),86.50%(173cases),89.50%(179cases), the coincidence rate of prevention is lowest,it’s 83.50(167cases). The result of elational analysis is that the relationship between curative effect and therapeutic principle, Prescription, composition is great, the relationship between economy and TCM diagnosis, syndrome classification, multi component of drug is great, the relationship between safety and multicomponent of drug is great, the regression analys about the application effect of X syndrome guide take about that, the accuracy of using syndrome has statistical significance to curative effect,the other had no statistical significance.ConclusionThe highest coincidence rate is TCM diagnosis and Western medicine diagnosis, slight lower is syndrome classification and therapeutic principle, the next the treatment, the coincidence rate of prevention is lowest. In the application effect part, the highest recognition is security, and next is economy. The result of elational analysis is that the relationship between curative effect and therapeutic principle, Prescription, composition is great, the relationship between economy and TCM diagnosis, syndrome classification, multicomponent of drug is great, the relationship between safety and multicomponent of drug is great, the regression analys about the application effect of X syndrome guide take about that, the accuracy of using syndrome has statistical significance to curative effect, the other had no statistical significance. The correct use of it will improve the clinical curative effect. The X syndrome guide has high coincidence degree and practicability, good safety and economy, we can improve the clinical curative effect accord to this study.